One of the big advantages of the Affordable Care Act is that previously uninsured people will now be able to afford coverage. One big benefit is that conditions can be treated in the early stages instead of after they get out of hand. Let's think about this a little.
I don't have any health insurance and I'm not feeling very well. Something's just not right. A doctor visit costs $100 and I just can't afford to go. I put it off for a month.... maybe 2.... maybe a year. The next thing I know, I've had a heart attack when I could have started taking a statin a year ago and avoided the whole thing.
Along comes the Affordable Care Act to save the day. Because I don't have much income, I qualify for a subsidy, which means I can get coverage for $60/month. It won't be easy, but I"ll find a way to pay for it. Now, here we go again... I'm not feeling well, I really should go to the doctor. But guess what. My $60/month Bronze plan has a $3000 deductible. It still costs me $100 to go to the doctor and not only couldn't I afford it before, now certainly can't afford it with a $60/month insurance payment. I still don't go to the doctor and I still have a heart attack. The difference now is that I have insurance to cover part (maybe only 50%) of the hospital bill. Seems like I'm just as sick and just as bankrupt either way.
I don't see how the "early stage detection" outcome is going to be achieved. Perhaps some will be discovered during a covered yearly physical exam, but from my experience: a) other than the routine blood work, there really isn't much depth to an annual physical exam, and b) if something is discovered, any likely required follow up is NOT covered until the deductible is reached. I couldn't afford $100 for a doctor visit, how am I going to afford $200 to see a specialist?
Friday, October 11, 2013
Wednesday, June 5, 2013
What Happens When The Money Runs Out
In a typical scenario, when I am no longer to care for myself due to illness or old age, and I have assets available, I check into a nursing home and pay the bills. When the money runs out my family can go through the arduous process of applying for Medicaid, and if I have followed all the rules over the past 60 months, the cost of my care from that point on will be covered by Medicaid.
What if I had no family? What if I didn't want to go through the Medicaid process? What if my family was incapable or unwilling to go through the paperwork. What if I didn't follow the rules? Maybe I bought new houses for my children 2 years ago. The money is no longer mine so the nursing home or government can't get it, but I didn't follow the rules, so I don't qualify for Medicaid. What would happen to me? Would they load me in an ambulance and take me..... where? Would they wheel me out to the curb and leave me? Would they put me in jail? Who will take care of me there? Will they administer a deadly drug? Or, would the state actually pay for my care in the end, regardless of if I followed the rules or not? What actually happens when the money runs out?
What if I had no family? What if I didn't want to go through the Medicaid process? What if my family was incapable or unwilling to go through the paperwork. What if I didn't follow the rules? Maybe I bought new houses for my children 2 years ago. The money is no longer mine so the nursing home or government can't get it, but I didn't follow the rules, so I don't qualify for Medicaid. What would happen to me? Would they load me in an ambulance and take me..... where? Would they wheel me out to the curb and leave me? Would they put me in jail? Who will take care of me there? Will they administer a deadly drug? Or, would the state actually pay for my care in the end, regardless of if I followed the rules or not? What actually happens when the money runs out?
Long Term Care Expenses
I was just at a seminar about how to fund long term care expenses conducted by a LTC insurance broker. Obviously this guy has a product to sell and he used all the typical scare tactics to convince the audience that his product was the only way out.
One of the things that absolutely turned me off about this guy was his attitude about Medicare and Medicaid. Basically, if you depend on programs such as these, you are expecting someone else to pick up the tab for your expenses, while if you buy his product, you are taking care of yourself. This is pure bullshit. ALL insurance is based on expecting someone else to pick up the tab for your expenses. All insured people pay premiums and claims are paid to those who need it. Medicare and Medicaid are no different. All people pay premiums (included in their taxes) and benefits are paid to those who need it.
One of the things that absolutely turned me off about this guy was his attitude about Medicare and Medicaid. Basically, if you depend on programs such as these, you are expecting someone else to pick up the tab for your expenses, while if you buy his product, you are taking care of yourself. This is pure bullshit. ALL insurance is based on expecting someone else to pick up the tab for your expenses. All insured people pay premiums and claims are paid to those who need it. Medicare and Medicaid are no different. All people pay premiums (included in their taxes) and benefits are paid to those who need it.
Friday, December 14, 2012
Connecticut Shootings
Let me start by saying this is one of the most horrible things I can imagine. My heart goes out to all of those in some way affected by this tragedy.
I wonder, though, if the sensationalism of the media actually fuels this kind of activity. I heard one network state that this was the 2nd worst mass killing behind Virginia Tech. How long will it be before someone tries to break the record? Why does NBC news need to spend the entire 1/2 hour of news talking about it, then an additional "special report" after that? Granted, it's news, but how much can you, or need you, say about it? Who knows what really motivates these sick, sick, sick people. But could the glory of all the press coverage be part of it?
Maybe it's time to get back to reporting the news instead of entertaining with the news.
I wonder, though, if the sensationalism of the media actually fuels this kind of activity. I heard one network state that this was the 2nd worst mass killing behind Virginia Tech. How long will it be before someone tries to break the record? Why does NBC news need to spend the entire 1/2 hour of news talking about it, then an additional "special report" after that? Granted, it's news, but how much can you, or need you, say about it? Who knows what really motivates these sick, sick, sick people. But could the glory of all the press coverage be part of it?
Maybe it's time to get back to reporting the news instead of entertaining with the news.
Tuesday, December 11, 2012
Right to Work
Unions have done some great things to help the working class rise up from the oppression of the "owners". People fought and died to have the right to join a union. Now, people have a right to join a union, without interference from their employer, yet in many states, they are not allowed to say, "This union isn't doing me any good, I don't want to be a part of it". I don't get it. What's wrong with being able to opt out of union membership? If the union has something worthwhile to sell, they should have no problem with membership. If they don't have anything worthwhile, why should people be compelled to buy?
Friday, September 14, 2012
Health Care: Pre-existing Conditions
Now that the convention is over and Mitt is the anointed Republican candidate, his story is starting to shift in an attempt to appeal to the masses. While the rhetoric before the convention was REPEAL OBAMACARE, now he is saying that parts of the law are good and should be kept. One of the parts that he likes is not allowing insurance companies to deny coverage based on pre-existing conditions.
First, by admitting that insurance companies should be compelled by law to insure a certain class of people is an admission that the free market economy will NOT deliver the best result for the people in all cases. It is not in any insurance company's interest to insure someone known to be sick.
Second, given that insurance is to be provided, how is it to be paid for. There are basically three scenarios. 1. You just add them to the pool of those already insured, in which case the cost of insurance goes up for everyone in order to cover the added expense of insuring people with known health issues. 2. You create "high risk pools" into which these people fall and for which insurance companies will provide coverage. Unfortunately, insurance companies are "for-profit" entities and they must set the premiums at a level that, on average, will cover the expenses of the group of sick people plus administrative overhead and profit. To take a simple example, let's say the "high risk pool" consists of people with cancer, the treatment of which costs $50,000/year. In order for the insurance company to survive, it must charge $50,000/year plus 15% for administration and profit. Who can afford that. 3. You can spread the risk, and cost across all people by insuring the healthy as well as the infirm. This is how insurance works, the people who are fortunate enough to never need it are the ones who pay for the less fortunate. This is exactly what the "individual mandate" in the affordable healthcare law is supposed to enable.
If you already have insurance and you really don't care if someone else does or not, I guess you're going to ignore this line of reasoning. Just remember though: as we learned in 2008, most of us are one "economic downturn" away from being jobless or switching jobs. When that happens, perhaps your current beloved insurance will no longer be available. If you've got diabetes, you're screwed.
Of the 3 options above, the only one that seems reasonable is exactly what the Affordable Care Act is trying to do. The biggest issue I have with it is that it keeps the "for-profit" insurance companies in the middle of the whole thing. Get them out of the way and go for a Single Payer system and we'll be on our way to a modern, affordable health care system.
First, by admitting that insurance companies should be compelled by law to insure a certain class of people is an admission that the free market economy will NOT deliver the best result for the people in all cases. It is not in any insurance company's interest to insure someone known to be sick.
Second, given that insurance is to be provided, how is it to be paid for. There are basically three scenarios. 1. You just add them to the pool of those already insured, in which case the cost of insurance goes up for everyone in order to cover the added expense of insuring people with known health issues. 2. You create "high risk pools" into which these people fall and for which insurance companies will provide coverage. Unfortunately, insurance companies are "for-profit" entities and they must set the premiums at a level that, on average, will cover the expenses of the group of sick people plus administrative overhead and profit. To take a simple example, let's say the "high risk pool" consists of people with cancer, the treatment of which costs $50,000/year. In order for the insurance company to survive, it must charge $50,000/year plus 15% for administration and profit. Who can afford that. 3. You can spread the risk, and cost across all people by insuring the healthy as well as the infirm. This is how insurance works, the people who are fortunate enough to never need it are the ones who pay for the less fortunate. This is exactly what the "individual mandate" in the affordable healthcare law is supposed to enable.
If you already have insurance and you really don't care if someone else does or not, I guess you're going to ignore this line of reasoning. Just remember though: as we learned in 2008, most of us are one "economic downturn" away from being jobless or switching jobs. When that happens, perhaps your current beloved insurance will no longer be available. If you've got diabetes, you're screwed.
Of the 3 options above, the only one that seems reasonable is exactly what the Affordable Care Act is trying to do. The biggest issue I have with it is that it keeps the "for-profit" insurance companies in the middle of the whole thing. Get them out of the way and go for a Single Payer system and we'll be on our way to a modern, affordable health care system.
Dredge the Rivers!
State Senator Tom Libous was interviewed about the need to dredge the rivers, presumably to avoid floods such as the one in September 2011. First, Mr. Libous stated that he's not an expert on this kind of stuff. And, he stated, even if he did know something about it, the rivers are under control of the Army Corps of Engineers, not state or local government. But Mr. Libous, not having any credentials or authority, said we should dredge the rivers.
To me this whole interchange was mildly amusing, until I realized that thousands of ignorant people will take up the chant and potentially wind up spending my tax money to to do something that will have little, if any effect on the potential for flooding in the future.
Just exactly what was the point of that interview anyhow??
To me this whole interchange was mildly amusing, until I realized that thousands of ignorant people will take up the chant and potentially wind up spending my tax money to to do something that will have little, if any effect on the potential for flooding in the future.
Just exactly what was the point of that interview anyhow??
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